1. Interleukin-23 inhibitors had a lower risk of developing paradoxical eczema when treated for plaque psoriasis compared to TNF inhibitors, IL-17 inhibitors and IL-12/23 2. Clinical features associated with increased paradoxical eczema risks included increasing age, history of atopic dermatitis, and history of hay fever. The risk was also lower in males. Evidence Rating Level:
Among patients with psoriasis treated with biologics, those receiving IL-23 inhibitors had the lowest risk of developing paradoxical eczema; women, older patients, and those with a history of atopic dermatitis or hay fever had an increased risk.
Ali Al-Janabi, MA, and associates found that 273 (1%) of approximately 25,000 drug exposures in 13,699 biologic-treated patients with psoriasis were associated with paradoxical eczema.
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